New Brunswick, once home to one of the most restrictive abortion regimes in Canada, has become the first province to say that it will offer the abortion pill for free.
Health Minister Victor Boudreau announced Tuesday that his government intends to make Mifegymiso, a two-drug combination that is considered the gold standard in medical-abortion drugs, available at no charge to all women with a valid health card.
The plan won't take effect until the alliance that negotiates drug prices on behalf of the provinces and territories reaches a deal with the manufacturer, but Mr. Boudreau is hoping that his promise of universal access will spur more doctors and pharmacists in his province to become certified to prescribe Mifegymiso.
"We wanted to be able to basically hit the ground running," Mr. Boudreau said in an interview with The Globe and Mail. "We felt that if we announced what our government's intention was well in advance it would motivate more physicians to take the course."
Right now, only 24 doctors and pharmacists in New Brunswick have registered to complete the online course. None have ordered the pills, according to Celopharma Inc., the drug's Canadian distributor.
But Paula Tenenbaum, the president of Celopharma, is confident that will change now that New Brunswick has agreed to eventually cover Mifegymiso.
Mifegymiso is made up of two medications, sold together in a combination pack. The first, mifepristone, blocks the hormone progesterone, causing the lining of the uterus to break down. The second drug, misoprostol, is taken 24 to 48 hours later, and induces contractions similar to a natural miscarriage.
Right now, Mifegymiso costs anywhere from $300 to $450, a price range that pro-choice advocates say is contributing to a slower-than-expected roll-out of the abortion pill across the country. Surgical abortions are, for the most part, covered by provincial health plans, although they're hard to obtain outside big cities.
Other provincial governments canvassed by The Globe on Tuesday said they are waiting for a formal recommendation on Mifegymiso from the Common Drug Review, the expert body that advises public drug plans on whether they should cover medications that are new to Canada.
The CDR's final report on the abortion pill is expected to be made public later this month.
Mifepristone, the first of the two medications that make up Mifegymiso, was not approved in Canada until July, 2015, decades after it was approved in places such as France and China, and 15 years after it was approved in the United States.
Sandeep Prasad, the executive director of Action Canada for Sexual Health and Rights, an Ottawa-based advocacy organization that connects women to abortion services, praised New Brunswick for vowing to cover all women, not just those who qualify for provincial drug coverage, such as social-assistance recipients.
"We need to see other provinces following New Brunswick's lead," he said.
Heather Hughes, the executive director of New Brunswick Right to Life, said she is distressed to see her province taking the lead in helping women end their unwanted pregnancies.
"For a province that is already cash-strapped … where does this money come from?" she asked. "Why is the government so determined to put money into abortion as birth control when they know that New Brunswickers are opposed to that?"
Ms. Hughes believes most people in New Brunswick preferred the old abortion regulations, which limited public funding for the procedure to terminations that were deemed "medically necessary" by two doctors and performed by an obstetrician.
Brian Gallant's Liberal government, which campaigned on reducing barriers to abortion, scrapped those rules at the start of 2015. However, it kept in place a rule limiting public funding for abortions to hospitals, meaning women have to pay out-of-pocket to end their pregnancies at the province's only private abortion clinic in Fredericton.
"I think [Mifegymiso] is another tool in our arsenal for providing better access to abortion services," said Allison Webster, a spokeswoman for Reproductive Justice NB, "but it's not the answer to all the access problems in New Brunswick."